Active NPI
George D Lyle, M.D.
- Otolaryngology Physician
- Winter Haven, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- ME64521
- Practice address
- 160 E Lake Howard Dr
Winter Haven, FL 33881-3155 - Phone
- (863) 299-1251
- Fax
- (863) 299-7666
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngic Allergy Physician | 207YX0602X | ME64521 | FL | |
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | ME64521 | FL | |
| Otolaryngology Physician | 207Y00000X | ME64521 | FL | Primary |
Addresses
Primary practice location
160 E Lake Howard Dr
Winter Haven, FL 33881-3155
Mailing address
8181 NW 154TH St Ste 200
Miami Lakes, FL 33016-5861
Phone (305) 558-3724
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 373177-400 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | glyle@barranco.medentdirect.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME64521 | FL | MD | Otolaryngology/Facial Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Barranco Clinic, P.a. | Otolaryngology | Current | Accepting new patients |
Locations
1920 Don Wickham Dr
Ste 215
Clermont, FL 34711
Phone (352) 394-8808
175 Patterson Rd
Haines City, FL 33844
Phone (863) 358-4849
8181 NW 154th St
Ste 200
Miami Lakes, FL 33016
Phone (225) 298-3537
160 E Lake Howard Dr
Winter Haven, FL 33881
Phone (863) 299-1251
Interoperability endpoints
- george.lyle.1@18417.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Otolaryngology Physician
- Winter Haven, FL
- NPI 1588697502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1831122811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8181 NW 154TH ST STE 200",
"city": "MIAMI LAKES",
"state": "FL",
"postal_code": "330165861",
"telephone_number": "305-558-3724",
"fax_number": "786-907-4485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 E LAKE HOWARD DR",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338813155",
"telephone_number": "863-299-1251",
"fax_number": "863-299-7666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYLE",
"first_name": "GEORGE",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0602X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngic Allergy",
"state": "FL",
"license": "ME64521",
"primary": false
},
{
"code": "207YX0905X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": "FL",
"license": "ME64521",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "FL",
"license": "ME64521",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "373177-400",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "glyle@barranco.medentdirect.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "160 E Lake Howard Dr",
"city": "Winter Haven",
"state": "FL",
"country_code": "US",
"postal_code": "338813155",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.